| Radiation Dose and Safety in Interventional Pain
Management with Fluoroscopy |
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Bong-Gil Seok , Sung-Gon Ha , Sang-Kuk Lee , Sang-Dae Kim, Se-Hoon Kim , Dong-Jun Lim , Jung-Yul Park |
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Department of Neurosurgery, Korea University College of Medicine, Seoul, Korea |
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| Abstract |
Object : The fluoroscopy is being used increasingly for interventional pain management. Various techniques of using
fluoroscopy may result in different spectrum of radiation exposure. In the past, authors have developed techniques
to minimize the radiation exposure by performing all interventional procedures with only one view (AP or PA) with
comparable clinical results. In this study, we have calculated the dose and time of fluoroscopy radiation from our
procedures, and then have evaluated the safety of such procedures.
Method: A total of randomly selected 1,000 patients who underwent interventional procedures with pain by a single
physician in recent 5 month period were included. Only one view was used in all patients when using C-arm fluoroscopy
with intermittent exposure technique. Date were collected on patients demographics, types of the procedure and
number of regions treated in each patient, and variable fluoroscopic time and radiation dose on each procedure.
Results
The average radiation time and radiation dose per patient were 5.2 seconds and 0.108 Gycm2 (0.0108
mREM), respectively, in facet joint nerve block of lumbar spine. In transforaminal epidural block, these were 16.2
seconds and 0.289 Gycm2, respectively. In cervical facet joint nerve block, these were averaged in 8.25 seconds and
0.1432 Gycm2. The average radiation dose of a patient was 0.54 Gycm2 regardless of the kind of procedure and the
frequency. The greatest radiation dose that was given to single patient was 1.05 Gycm2. When we compared annual
maximum permissible done, the radiation dose that the patients and physicians were exposed during procedure
was in range of safety. In addition, the radiation dose and time were less and shorter than other reported series.
Conclusion
Interventional pain management with fluoroscopy using radiation protection device is considered a
safe procedure in treatment of spinal disorder patients for pain relieve and improvement of quality of life. This is
especially true when radiation is used as minimum as possible (using only single AP or PA view with intermittent
exposure in our case), while providing comparable clinical results. |
| Key Words:
Interventional pain management⋅Fluoroscopy⋅Radiation⋅Exposure⋅Safety |
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